I am the job

This year, I had the chance to take Christmas off, and I was happy to take a nice long weekend, but I find that I can't stop thinking about patient care items. One of the strange things about being on vacation is that it's not so much a vacation from a location as much as it is a vacation from the profession. No more decisions, I just want to relax. But I realize now that I've done something quite dangerous: I have become the job.

Even in my regular life, it shows. I don't do much outside the medical world. I eat out sometimes. I go to coffee shops. But most of my time is spent simply waiting to get back to being a doctor. Outside of the white coat, I'm not sure who I am.

So, I need to find myself a little and start enjoying life, now that I've got some time to do just that. But how do you go about getting a life? I'm really not sure. If it takes more effort than going to Starbucks, I might be in trouble.

Get a job

I haven't really talked about it much, but I have a job for July. I've taken a position in general internal medicine, and that's all I have to say, but it was a very trying experience, finding a job in general medicine. There are only so many kinds of jobs in gen med:

(1) The fantastic hospitalist job in the middle of nowhere: $300k, full benefits, an expense account at the local strip club, and free cheese 24 hours a day, but the position is in Nome, Alaska.

(2) The pitiful, pitiful, pitiful position: $100k, traditional, replacing a solo practice doctor in middle of nowhere, Maine, with call every day, in a community of 500, supported by a 10 bed hospital. Part of reimbursement in the form of soy beans.

(3) The position far, far too good for you: $500k, all outpatient, in Laguna Beach, catering specifically to swimsuit models in need of paps/pelvics and breast exams, with pace of 5 patients a day, cappuccino machines in every exam room, secretary to take notes while you see patients, and complimentary trophy wife if you are single (mistress if married). Shorts and t-shirt dress code. Nip/Tuck policy on sex with patients.

(4) The academic position: You don't want to know the money. Publish or perish. Office in ivory tower only available after 15+ years. Clinical acumen not required. Must be able to survive in relative poverty.

(5) The reasonable spot: $150k, good benefits, 1 in 5 call, medium sized town, good schools, great if you have a wife and kids, but you have managed to finish med school and residency and you're still not married, so the idea of white picket fences and little league games makes you a little sick inside.

Visions of the future

Zoltar's Hands by Roadsidepictures

The dumbest questions sometimes are the most obvious ones. When I was interviewing for a job after residency, I interviewed with a few private practice groups. They were a mix of very, very eager to mildly indifferent. Their questions mainly centered on the most obvious issues: will you stay with us?

They got to the point in a multitude of ways. One interviewer wanted to know if I had family in the area, or what I thought of their city, or whether I liked their local sports team.

The dumbest question I got though was a common residency interview question: "Where do you see yourself in five years?" Now, this seems like a good question, right? But really, when you're interviewing for private practice jobs, there's no such thing as advancement, just partnership. If they hired me on, I'd be doing the same thing in five years, but hopefully as a partner. It'd be like asking retirees where they see themselves in five years: hopefully not dead, hopefully still retired.

My reply? "Umm... working for you?" I didn't know what he wanted me to say. Did he want me to say, "Well, I thought I might meet the girl of my dreams while wandering the clean streets of your fair city, and we'd fall in love, attend performances by the local symphony orchestra, and have a child who will one day attend the local university."

Maybe he wanted a more truthful answer: "I hope to be the first person to have full season ticket packages in baseball, football, and hockey all at the same time." Or perhaps something better? "I see myself driving a BMW and eating fruit off the breasts of a $10,000 hooker." I just don't see the point to his question.

I think the nice thing about private practice interviews is that people can talk straight, no bullshit. For example, one place I interviewed at handled the question like so: "Alright, you seem like a good guy. If we take you on, are you gonna stay here, or are you gonna leave after 2 years?" If only all intereviewers could be this clear.